Remote neurocognitive interventions for attention-deficit/hyperactivity disorder – opportunities and challenges

Abstract

Improving neurocognitive functions through remote interventions has been a promising approach to developing new treatments for attention-deficit/hyperactivity disorder (AD/HD). Remote neurocognitive interventions may address the shortcomings of the current prevailing pharmacological therapies for AD/HD, e.g., side effects and access barriers. Here we review the current options for remote neurocognitive interventions to reduce AD/HD symptoms, including cognitive training, EEG neurofeedback training, transcranial electrical stimulation, and external cranial nerve stimulation. We begin with an overview of the neurocognitive deficits in AD/HD to identify the targets for developing interventions. The role of neuroplasticity in each intervention is then highlighted, due to its essential role in facilitating neuropsychological adaptations. Following this, each intervention type is discussed in terms of the key details of the intervention protocols, the role of neuroplasticity, and the available evidence. Finally, we offer suggestions for future directions in terms of optimizing the existing intervention protocols and developing novel protocols.

Perspectives on heterogeneity-informed cognitive training for attention-deficit/hyperactivity disorder

“…Then, the defined responders are characterized by a group comparison (responder vs. non-responders) or regression analysis. However, this method of determining responders may suffer regression toward the mean because of measurement errors [for more discussion and alternative models, please see Castro-Schilo and Grimm ( 44 ) and ( 30 , 45 )]. The second issue refers to generalizability.…”

“…Non-computerized CT is a broader term, encompassing multiple forms, such as board games based on the Corsi block task to train working memory ( 23 ) and physical activity based on the “Simon Says” task to train inhibition ( 62 ). Computerized CT offers the advantages of precisely controlling training content (e.g., training duration and difficulty) and requires less manual guidance, whereas non-computerized CT is more cost-effective and ecological ( 45 ).…”

“…Secondly, CT can be used in conjunction with interventions that enhance neuroplasticity. This combination is grounded on the points that neuroplasticity is a prerequisite for CT improvement, and interventions that enhance neuroplasticity can thus improve training effects ( 45 ). Following this perspective, attempts have been made to combine CT with non-invasive brain stimulation; however, the results are inconsistent [see Dakwar-Kawar et al ( 70 ) but also Westwood et al ( 71 )].…”

“…Following this perspective, attempts have been made to combine CT with non-invasive brain stimulation; however, the results are inconsistent [see Dakwar-Kawar et al ( 70 ) but also Westwood et al ( 71 )]. The disparity may be due to the different timing and intensity at which brain stimulation was delivered, as the impact of the same brain stimulation on neuroplasticity varies with both time and intensity ( 45 , 72 ). Further exploration of the mechanisms underlying non-invasive brain stimulation may lead to more effective combinations.…”